AB768-ASA1,453,224
628.10
(2) (cm)
For liability for delinquent taxes. The commissioner shall
25revoke the license of an intermediary, including a temporary license under s. 628.09,
1if the department of revenue certifies under s. 73.0301 that the intermediary is liable
2for delinquent taxes.
AB768-ASA1, s. 575b
3Section 575b. 628.10 (2) (d) of the statutes, as created by 1997 Wisconsin Act
4.... (Senate Bill 494), is amended to read:
AB768-ASA1,453,155
628.10
(2) (d) (title)
For failure to provide social security or federal employer
6identification number. If an intermediary
who is a natural person fails to provide a
7social security number
or federal employer identification number as required under
8s. 628.095 (3), the commissioner shall suspend or limit the license of the
9intermediary, effective the day following the last day on which the annual fee under
10s. 601.31 (1) (m) may be paid, if the commissioner has given the intermediary
11reasonable notice of when the fee must be paid to avoid suspension or limitation. If
12the intermediary provides the social security number
or federal employer
13identification number within 60 days from the effective date of the suspension, the
14commissioner shall reinstate the intermediary's license effective as of the date of
15suspension.
AB768-ASA1,453,2418
628.34
(3) (a) No insurer may unfairly discriminate among policyholders by
19charging different premiums or by offering different terms of coverage except on the
20basis of classifications related to the nature and the degree of the risk covered or the
21expenses involved, subject to ss. 632.365,
632.745
632.746 and 632.748. Rates are
22not unfairly discriminatory if they are averaged broadly among persons insured
23under a group, blanket or franchise policy, and terms are not unfairly discriminatory
24merely because they are more favorable than in a similar individual policy.
AB768-ASA1, s. 576b
1Section 576b. 632.68 (2) (b) (intro.) of the statutes, as affected by 1997
2Wisconsin Act .... (Senate Bill 494), is repealed and recreated to read:
AB768-ASA1,454,113
632.68
(2) (b) (intro.) A person may apply to the commissioner for a viatical
4settlement provider license on a form prescribed by the commissioner for that
5purpose. The application form shall require the applicant to provide the applicant's
6social security number, if the applicant is a natural person, or the applicant's federal
7employer identification number, if the applicant is not a natural person. The fee
8specified in s. 601.31 (1) (mm) shall accompany the application. After any
9investigation of the applicant that the commissioner determines is sufficient, the
10commissioner shall issue a viatical settlement provider license to an applicant that
11satisfies all of the following:
AB768-ASA1, s. 577b
12Section 577b. 632.68 (2) (b) 2. of the statutes, as affected by 1997 Wisconsin
13Act .... (Senate Bill 494), is repealed and recreated to read:
AB768-ASA1,454,1514
632.68
(2) (b) 2. Provides complete information on the application, including
15the applicant's social security number or federal employer identification number.
AB768-ASA1, s. 577m
16Section 577m. 632.68 (2) (bc) of the statutes, as created by 1997 Wisconsin Act
17.... (Senate Bill 494), is renumbered 632.68 (2) (bc) 1.
AB768-ASA1,454,2119
632.68
(2) (bc) 2. The commissioner may disclose a social security number or
20federal employer identification number received under par. (b) or (e) to the
21department of revenue for the purpose of requesting certifications under s. 73.0301.
AB768-ASA1, s. 578m
22Section 578m. 632.68 (2) (bm) of the statutes, as created by 1997 Wisconsin
23Act .... (Senate Bill 494), is renumbered 632.68 (2) (bm) 1.
AB768-ASA1,455,3
1632.68
(2) (bm) 2. Notwithstanding par. (b), the commissioner may not issue
2a license under this subsection if the department of revenue certifies under s.
373.0301 that the applicant is liable for delinquent taxes.
AB768-ASA1, s. 580m
4Section 580m. 632.68 (2) (cm) of the statutes, as created by 1997 Wisconsin
5Act .... (Senate Bill 494), is renumbered 632.68 (2) (cm) 1.
AB768-ASA1,455,97
632.68
(2) (cm) 2. If the commissioner denies an application for a license under
8this subsection for delinquent taxes, the applicant is entitled to a hearing under s.
973.0301 (5) (a) but is not entitled to a hearing under par. (c).
AB768-ASA1, s. 582b
10Section 582b. 632.68 (2) (e) of the statutes, as affected by 1997 Wisconsin Act
11.... (Senate Bill 494), is repealed and recreated to read:
AB768-ASA1,455,1612
632.68
(2) (e) Except as provided in sub. (3), a license issued under this
13subsection shall be renewed annually on the anniversary date upon payment of the
14fee specified in s. 601.31 (1) (mp) and upon providing the licensee's social security
15number or federal employer identification number, as applicable, if not previously
16provided on the application for the license or at a previous renewal of the license.
AB768-ASA1, s. 584m
17Section 584m. 632.68 (3) (b) of the statutes, as created by 1997 Wisconsin Act
18.... (Senate Bill 494), is renumbered 632.68 (3) (b) 1.
AB768-ASA1,455,2220
632.68
(3) (b) 2. The commissioner shall revoke or refuse to renew a viatical
21settlement provider license if the department of revenue certifies under s. 73.0301
22that the licensee is liable for delinquent taxes.
AB768-ASA1, s. 586b
23Section 586b. 632.68 (4) (b) of the statutes, as affected by 1997 Wisconsin Act
24.... (Senate Bill 494), is repealed and recreated to read:
AB768-ASA1,456,8
1632.68
(4) (b) A person may apply to the commissioner for a viatical settlement
2broker license on a form prescribed by the commissioner for that purpose. The
3application form shall require the applicant to provide the applicant's social security
4number, if the applicant is a natural person, or the applicant's federal employer
5identification number, if the applicant is not a natural person. The fee specified in
6s. 601.31 (1) (mr) shall accompany the application. The commissioner may not issue
7a license under this subsection unless the applicant provides his or her social security
8number or its federal employer identification number, whichever is applicable.
AB768-ASA1, s. 586m
9Section 586m. 632.68 (4) (bc) of the statutes, as created by 1997 Wisconsin Act
10.... (Senate Bill 494), is renumbered 632.68 (4) (bc) 1.
AB768-ASA1,456,1412
632.68
(4) (bc) 2. The commissioner may disclose a social security number or
13federal employer identification number received under par. (b) or (c) to the
14department of revenue for the purpose of requesting certifications under s. 73.0301.
AB768-ASA1, s. 587m
15Section 587m. 632.68 (4) (bm) of the statutes, as created by 1997 Wisconsin
16Act .... (Senate Bill 494), is renumbered 632.68 (4) (bm) 1.
AB768-ASA1,456,2018
632.68
(4) (bm) 2. The commissioner may not issue a license under this
19subsection if the department of revenue certifies under s. 73.0301 that the applicant
20is liable for delinquent taxes.
AB768-ASA1, s. 589c
21Section 589c. 632.68 (4) (c) of the statutes, as affected by 1997 Wisconsin Act
22.... (Senate Bill 494), is repealed and recreated to read:
AB768-ASA1,457,223
632.68
(4) (c) Except as provided in sub. (5), a license issued under this
24subsection shall be renewed annually on the anniversary date upon payment of the
25fee specified in s. 601.31 (1) (ms) and upon providing the licensee's social security
1number or federal employer identification number, as applicable, if not previously
2provided on the application for the license or at a previous renewal of the license.
AB768-ASA1, s. 591m
3Section 591m. 632.68 (5) (b) of the statutes, as created by 1997 Wisconsin Act
4.... (Senate Bill 494), is renumbered 632.68 (5) (b) 1.
AB768-ASA1,457,86
632.68
(5) (b) 2. The commissioner shall revoke or refuse to renew a viatical
7settlement broker license if the department of revenue certifies under s. 73.0301 that
8the licensee is liable for delinquent taxes.
AB768-ASA1,457,1511
632.7495
(1) (a) Except as provided in subs. (2)
and (3) to (4) and
12notwithstanding s. 631.36 (2) to (4m), an insurer that provides individual health
13benefit plan coverage shall renew such coverage or continue such coverage in force
14at the option of the insured individual and, if applicable, the association through
15which the individual has coverage.
AB768-ASA1,457,1917
632.7495
(4) Notwithstanding subs. (1) and (2) and s. 631.36 (4), an insurer is
18not required to renew individual health benefit plan coverage that is marketed and
19designed to provide short-term coverage as a bridge between coverages.
AB768-ASA1,458,2
21632.853 Coverage of drugs and devices. A health care plan, as defined in
22s. 628.36 (2) (a) 1., or a self-insured health plan, as defined in s. 632.85 (1) (c), that
23provides coverage of only certain specified prescription drugs or devices shall develop
24a process through which a physician may present medical evidence to obtain an
25individual patient exception for coverage of a prescription drug or device not
1routinely covered by the plan. The process shall include timelines for both urgent
2and nonurgent review.
AB768-ASA1,458,5
4632.855 Requirements if experimental treatment limited. (1) 5Definitions. In this section:
AB768-ASA1,458,66
(a) "Health care plan" has the meaning given in s. 628.36 (2) (a) 1.
AB768-ASA1,458,77
(b) "Self-insured health plan" has the meaning given in s. 632.85 (1) (c).
AB768-ASA1,458,11
8(2) Disclosure of limitations. A health care plan or a self-insured health plan
9that limits coverage of experimental treatment shall define the limitation and
10disclose the limits in any agreement, policy or certificate of coverage. This disclosure
11shall include the following information:
AB768-ASA1,458,1212
(a) Who is authorized to make a determination on the limitation.
AB768-ASA1,458,1413
(b) The criteria the plan uses to determine whether a treatment, procedure,
14drug or device is experimental.
AB768-ASA1,458,22
15(3) Denial of treatment. A health care plan or a self-insured health plan that
16receives a request for prior authorization of an experimental procedure that includes
17all of the required information upon which to make a decision shall, within 5 working
18days after receiving the request, issue a coverage decision. If the health care plan
19or self-insured health plan denies coverage of an experimental treatment,
20procedure, drug or device for an insured who has a terminal condition or illness, the
21health care plan or self-insured health plan shall, as part of its coverage decision,
22provide the insured with a denial letter that includes all of the following:
AB768-ASA1,458,2423
(a) A statement setting forth the specific medical and scientific reasons for
24denying coverage.
AB768-ASA1,459,2
1(b) Notice of the insured's right to appeal and a description of the appeal
2procedure.
AB768-ASA1,459,105
632.895
(11) (a) (intro.)
Every Except as provided in par. (e), every disability
6insurance policy, and every self-insured health plan of the state or a county, city,
7village, town or school district, that provides coverage of any diagnostic or surgical
8procedure involving a bone, joint, muscle or tissue shall provide coverage for
9diagnostic procedures and medically necessary surgical or nonsurgical treatment for
10the correction of temporomandibular disorders if all of the following apply:
AB768-ASA1,459,1614
632.895
(11) (c) 2. Notwithstanding subd. 1., the coverage required under this
15subsection for diagnostic procedures and medically necessary nonsurgical treatment
16for the correction of temporomandibular disorders may not exceed $1,250 annually.
AB768-ASA1,459,2218
632.895
(11) (d) Notwithstanding par. (c) 1., an insurer or a self-insured health
19plan of the state or a county, city, village, town or school district may require that an
20insured obtain prior authorization for any diagnostic procedures or medically
21necessary surgical or nonsurgical treatment for the correction of
22temporomandibular disorders.
AB768-ASA1,459,2424
632.895
(11) (e) This subsection does not apply to any of the following:
AB768-ASA1,459,2525
1. A disability insurance policy that covers only dental care.
AB768-ASA1,460,1
12. A medicare supplement policy, as defined in s. 600.03 (28r).
AB768-ASA1,460,94
632.895
(12) (b) (intro.)
Every Except as provided in par. (d), every disability
5insurance policy, and every self-insured health plan of the state or a county, city,
6village, town or school district, shall cover hospital or ambulatory surgery center
7charges incurred, and anesthetics provided, in conjunction with dental care that is
8provided to a covered individual in a hospital or ambulatory surgery center, if any
9of the following applies:
AB768-ASA1,460,1211
632.895
(12) (d) This subsection does not apply to a disability insurance policy
12that covers only dental care.
AB768-ASA1, s. 595
13Section
595. 632.897 (4) (d) (intro.) of the statutes is amended to read:
AB768-ASA1,460,2114
632.897
(4) (d) (intro.) This subsection does not require individual coverage to
15be offered by an insurer offering group policies only. This subsection does not require
16an insurer to issue
, or continue in force, an individual conversion policy covering a
17terminated insured or his or her spouse or dependent if benefits provided or available
18to the covered person under subds. 1. to 3., together with the converted policy's
19benefits, would result in overinsurance according to the insurer's standards for
20overinsurance, and these standards have been filed with and approved by the
21commissioner prior to use:
AB768-ASA1,460,2323
633.14
(2) (d) Provides its federal employer identification number.
AB768-ASA1, s. 597m
24Section 597m. 633.14 (2c) of the statutes, as created by 1997 Wisconsin Act
25.... (Senate Bill 494), is renumbered 633.14 (2c) (a).
AB768-ASA1,461,42
633.14
(2c) (b) The commissioner may disclose any information received under
3sub. (1) (d) or (2) (d) or s. 633.15 (1m) to the department of revenue for the purpose
4of requesting certifications under s. 73.0301.
AB768-ASA1, s. 598m
5Section 598m. 633.14 (2m) of the statutes, as created by 1997 Wisconsin Act
6.... (Senate Bill 494), is renumbered 633.14 (2m) (a).
AB768-ASA1,461,108
633.14
(2m) (b)
Notwithstanding subs. (1) and (2), the commissioner may not
9issue a license under this section if the department of revenue certifies under s.
1073.0301 that the applicant is liable for delinquent taxes.
AB768-ASA1, s. 600
11Section
600. 633.15 (1m) of the statutes, as created by 1997 Wisconsin Act ....
12(Senate Bill 494), is repealed and recreated to read:
AB768-ASA1,461,1813
633.15
(1m) Social security or federal employer identification number. At
14an annual renewal, an administrator shall provide his or her social security number,
15if the administrator is an individual, or its federal employer identification number,
16if the administrator is a corporation, limited liability company or partnership, if the
17social security number or federal employer identification number was not previously
18provided on the application for the license or at a previous renewal of the license.
AB768-ASA1, s. 600c
19Section 600c. 633.15 (2) (a) (title) of the statutes, as affected by 1997
20Wisconsin Act .... (Senate Bill 494), is amended to read:
AB768-ASA1,461,2221
633.15
(2) (a) (title)
Nonpayment of annual renewal fee or failure to provide
22social security number or federal employer identification number.
AB768-ASA1, s. 600d
23Section 600d. 633.15 (2) (a) 1. of the statutes, as affected by 1997 Wisconsin
24Act .... (Senate Bill 494), is amended to read:
AB768-ASA1,462,6
1633.15
(2) (a) 1. If an administrator fails to pay the annual renewal fee as
2provided under sub. (1) or fails to provide a social security number
or federal
3employer identification number as required under sub. (1m), the commissioner shall
4suspend the administrator's license effective the day following the last day when the
5annual renewal fee may be paid, if the commissioner has given the administrator
6reasonable notice of when the fee must be paid to avoid suspension.
AB768-ASA1, s. 600e
7Section 600e. 633.15 (2) (a) 2. of the statutes, as affected by 1997 Wisconsin
8Act .... (Senate Bill 494), is amended to read:
AB768-ASA1,462,139
633.15
(2) (a) 2. If, within 60 days from the effective date of suspension under
10subd. 1., an administrator pays the annual renewal fee or provides the social security
11number
or federal employer identification number, or both if the suspension was
12based upon a failure to do both, the commissioner shall reinstate the administrator's
13license effective as of the date of suspension.
AB768-ASA1, s. 600f
14Section 600f. 633.15 (2) (a) 3. of the statutes, as affected by 1997 Wisconsin
15Act .... (Senate Bill 494), is amended to read:
AB768-ASA1,462,1916
633.15
(2) (a) 3. If payment is not made or the social security number
or federal
17employer identification number is not provided within 60 days from the effective date
18of suspension under subd. 1., the commissioner shall revoke the administrator's
19license.
AB768-ASA1, s. 601
20Section
601. 633.15 (2) (b) 1. (intro.) of the statutes, as affected by 1997
21Wisconsin Act .... (Senate Bill 494), is amended to read:
AB768-ASA1,462,2422
633.15
(2) (b) 1. (intro.) Except as provided in
par. pars. (c)
and (d), the
23commissioner may revoke, suspend or limit the license of an administrator after a
24hearing if the commissioner makes any of the following findings: